The Risks of Youth E-Cig Use

Electronic cigarettes may pose risks to children and adolescents

(RxWiki News) Experimenting is often how kids and teens learn. Experimenting with electronic cigarettes, however, may be risky.

A new review of research on e-cigarettes found that these devices were a high-growth market in the US — particularly among adolescents. In fact, more young people used e-cigs than conventional cigarettes. These products have not been well-studied, and their health risks are unknown, the author of this study said.

Parents and pediatricians should recognize the risks related to nicotine exposure from e-cigs, said study author Dean E. Schraufnagel, MD. These risks may include addiction and risks tied to poor regulation of e-cigs.

"Because adolescents are attracted to the electronic and modern aspects of these nicotine delivery systems, parents need to be vigilant about their kids' use," said Garry Sigman, MD, director of the pediatric weight management program and adolescent medicine program at Loyola University Health System, in an interview with dailyRx News. "If they can engage the teen in discussion about this, they should reiterate ... that the comparison between E-Cigarettes and regular cigarettes is not the right comparison. It should be about comparing the inhaling of E-Cigarettes (that have an addictive and poisonous substance as a primary ingredient and chemical mixtures that have not been shown to be safe) to inhaling nothing."

Dr. Sigman continued, "While parents cannot completely counteract the advertising and marketing campaigns targeted to youth, they can arm themselves and their kids with knowledge and supplement with good parenting practices of setting rules, and monitoring behavior."

Dr. Schraufnagel, of the University of Illinois at Chicago, wrote that “the benefit that may be gained by certain smokers in reducing the amount of combustible cigarettes they use must be weighed by the great potential of increasing nicotine addiction in the world. Youth are particularly vulnerable because of the effect of nicotine on developing neural tissue, risk of lifelong addiction, heavy and clever promotion by the industry, and the ease of access of these products.”

E-cigs were developed in 2003 by Chinese pharmacist Hon Lik. These battery-powered devices heat a nicotine solution to produce a flavored vapor the user inhales. Nicotine is the primary addictive compound in tobacco.

Some believe e-cigs are less harmful than conventional cigarettes. Former and current smokers often use them to stop smoking or prevent relapse after quitting. Research on this topic so far has been limited.

Dr. Schraufnagel said e-cigs were no more effective than a placebo (fake treatment) in helping people stop smoking.

Nicotine, Dr. Schraufnagel said, is a toxic and addictive substance known to cause damage to babies who are exposed if the mother smokes while pregnant. Nicotine has also been linked to obesity, high blood pressure, respiratory problems and lung cancer.

Within 10 years of when e-cigs first became available, 25 percent of US high school students said they had tried them. By 2013, 12 percent of high school students said they were current users.

More than half of those polled said e-cigs were the first nicotine product they had tried. This suggests that the products may be marketed to attract new users to nicotine, Dr. Schraufnagel said. Sweet flavors — long banned in conventional cigarettes — were most popular among users.

Past research has found that e-cigs may expose users to contaminants like fungi, bacteria, toxic metals, silicates and cancer-causing agents, Dr. Schraufnagel noted.

E-cigs do not come in child-proof containers. A small child who swallows a nicotine cartridge can become very ill or even die.

Because e-cigs are not regulated, they may not be manufactured according to any safety standard.

Children and adolescents are more susceptible to addiction because their brains are still developing, Dr. Schraufnagel said.

“The hazard is that electronic cigarettes normalize [smoking]," Dr. Schraufnagel wrote. "Glamorizing vaping euphemizes and disguises the willful ingestion of an addicting and highly toxic substance. The risk is that electronic cigarettes will create a new nicotine-dependent world similar to what tobacco did in the last century.”

This study was published April 21 in the journal Pediatric Allergy, Immunology, and Pulmonology.

Dr. Schraufnagel disclosed no funding sources or conflicts of interest.

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